T Nation

Testosterone Increase Action Plan

(Seriously long time lurker bout 10 years haha, finally joined thought I’d add a post for your info)

I’m UK based, went to GP low test and symptoms (from memory I think my test was just on bottom 12.something and free test was below scale), went with medichecks info and he dismissed it, then did bloods with gp which came back exactly the same (apart from he didn’t test free T or shbg). He then looked at me and said “sometimes we just treat the symptoms and not the cause” - then wrote a script for Viagra and antidepressants, I didn’t bother even picking these up. Went to BMH and that was 2 years ago they’ve been spot on in terms of treatment, I’ve been in 125ml of Sustanon e5d, for 2 years I’ve also got a script for anastrazole 0.5 e5d but don’t feel this is necessary so generally don’t take it. Protocol works well and I am one of the easy success stories (well I think I have thyroid issues but that’s a different story, ongoing, ED is solved and I can finally grow a beard - although about the same time I got on trt I got a job which prohibits beards…).

Long post short NHS will probably not even give you trt (even though NICE guidelines are certainly applicable to you) even if they do, you probably won’t want them to!

Rough costs for BMH: very rough prices £90 per month for meds, £150 bloods every 6 months (although initial treatment will require 3 tests all showing low test, plus you’ll need a 6 week test after treatment) £150 for dr’s consult every year (I think). I get my consumables in bulk from a different company (they charge about £10 for 1 month’s supply when you can buy two years worth for about £25).

Hope that helps!

Thank you for your reply and your help!

I am looking forward to what the clinic recommends. I guess I was just looking at whether 10.9 is low enough, Obviously at 6 and 7 it was, but I guess 10.9 is still super low as I am still experiencing symptoms. Hopefully he can piece it all together and is able to decipher why E2 and Test are low, and prolactin is super high, and recommend the correct treatment to sort this out

10 is low enough - bit of further info for you:

  • Regarding the thresholds for treatment intervention in symptomatic men, British Society for Sexual Medicine (BSSM) and International Society for Sexual Medicine (ISSM) guidelines recommend the following:
    • TT level lower than 8 nmol/l or FT level lower than 180 pmol/l (<0.180 nmol/l; based on 2 separate levels from 8 to 11 AM) usually requires testosterone therapy
    • TT level higher than 12 nmol/l or FT level higher than 225 pmol/l (>0.225 nmol/l) does not require testosterone therapy
    • levels from 8 to 12 nmol/l might require a trial of testosterone therapy for a minimum of 6 months based on symptoms
  • BSSM guidelines also state:
    • a FT level lower than 225 pmol/l (0.225 nmol/l) provides supportive evidence for testosterone therapy in the presence of appropriate symptoms

You’re symptomatic and within levels should be able to get NHS treatment, but they’ll likely offer a poor protocol. My FT was just at bottom of range and NHS wouldn’t even test free T (which was below range), GP wouldn’t refer to an endo, you might have a better experience .but if you don’t I’d be confident BMH will work with you.

Hi guys,

So I had my NHS appointment this morning, of course I was refused treatment, but I thought I would highlight some interesting points from it…

  1. I was told that LH & FSH is secreted from the hypothalamus.

  2. If I truly had a testosterone deficiency I would be anaemic.

  3. I was told TRT is only prescribed after a reading of 4 nmol/L or less.

  4. My E2 should be very low and the low E2 reading is nothing to worry about as it is the female hormone

  5. If I had a true testosterone deficiency my LH & FSH reading would be extremely high

  6. All of my tests (6.6 , 7.6 and 10.9 nmols) are all in range and perfectly normal

  7. Take Cialis and consider counselling and potentially anti depressants for the depersonalization and low mood.

I’m not quite sure what to say. I know I wasn’t expecting much but jeez…
I have my appointment next week with a private TRT clinic, I am hoping for much more…

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Yeah, that’s pretty crazy. Totally expected, but still crazy. You should have a much different experience at the private clinic if it’s a decent one. Hopefully anyways.

Just so you can wrap your head around this, 4 nmol/L is 115 ng/dL!! I doubt there are many men alive today at these levels.

The person making these statements was never properly educated in sex hormones and it shows. This post belongs is Stupid Things That Docs Do and Say thread.

This would depend, secondary hypogonadism would see low LH and primary hypogonadism high LH.

This is what doctors were trained to do, in this case it’s cruelty as show cracks in our medical systems.

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Hi guys, thought I would give you an update to let you all know that I received my testosterone deficiency diagnosis from my private appointment and have now commenced TRT. Due to my low SHBG and other reasons, my starting protocol is as follows…

12.5mg Test Cyp daily Sub-Q
100iu HCG Daily Sub-Q

I do want to be fertile at the moment which is the reason for the HCG. I understand this is quite a low dose? This is just the starting protocol and we can see from there, I imagine the dose will be increased once we have had a good amount of time to analyze how I feel and look at numbers etc

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Hi guys,

So I have just done my first 2 weeks and the daily injections are now just a part of my routine, I flick the kettle on, and before it has boiled they are done. For anyone who fears TRT (as I did), it really is nothing once you get the hang of it. I was initially concerned with the injections, but I use a half inch 29g and I really do not feel a thing.

Of course I am only 2 weeks in and not expecting a difference yet, and I havent felt any either, but I am excited and happy to now be at the start pf the right track. A quick (and really novice question) but everyone seems to state their dose in a weekly unit, so would mine be 87.5 mg a week? How does that fair with others starting dose, this is considered low?


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Your dose might be quite low, but lets wait and see. It takes 6 weeks to build up.
Also it is better to start without HCG, but you might get optimised this way as well.
I for example inject 20mg daily and 100ui HCG daily and this has put me to very high total t levels - around 1450ng/dl, but seems Im over responder to HCG. Without HCG I would be probable around 1000-1100 only with 20mg test daily

Do you inject test and hcg in one syringe? I didnt learn how to load them together all ways I tried it becomes a mess

Thanks. Yeah I guess my Dr wants to start my test low to see how I respond with the HCG aswell and notch it up from there when required. Too early for me to say as only 2 weeks in.
No, two seperate injections. I was advised not to mix both and to keep them seperately due to one being water and the other oil based

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I can assure you they can be injected together and there is no problem, except it is very difficult to draw them together with the precise quantities. Some people are doing it

Maybe thats all my Dr meant, not that it CANT be done, but rather just do it like this as its easier lol

I inject them together. Draw HCG first then Test. They stay separate and it guarantees that there is no T wasted since it goes in first.

With what needle? For me drawing test is very complicated I pull the plunger and wait a lot for the syringe to fill in. Then have to push some back in the vial or outside to adjust the test qty

I use a 27.5 needle. HCG pulls easy, as it’s just water then i hold the plunger while injecting into the test vial, so the pressure doesn’t pull in the HCG, and then draw. Easy peasy. They stay separate Test on top, HCG on bottom.

have any chance of making a simple video for that :slight_smile:
I think I understood but would like to see it

Mine was 123 when my doc finally put me on T.

What makes a person symptomatic compared to someone else though? For example, I know of some who have had a total T of 11 nmols and been okay… I had 6, 7 and 10nmols and didn’t feel good with awful erections, and no morning or nocturnal ones. Is it a case of free T and E2 etc? Someone may have a total of 11nmols but mid range free and E2 and therfore feel okay? Everything of mine was tanked… total, free and E2, so no wonder I was/am struggling

There are some theories regarding androgen receptor density and sensitivity that answer that. I don’t know a lot of the details though.